毫针速刺法联合推拿对颈源性眩晕患者脑血流动力学的影响  

Effect of fast filiform needle acupuncture combined with message on cerebral hemodynamics in patients with cervicogenic vertigo

作　　者：何雷 黄谦[1] 张磊[1] 李志伟[1] HE Lei;HUANG Qian;ZHANG Lei;LI Zhiwei(Lianyungang Affiliated Hospital of Nanjing University of Chinese Medicine,Lianyungang 222000,Jiangsu,China)

机构地区：[1]南京中医药大学连云港附属医院,江苏连云港222000

出　　处：《现代中西医结合杂志》2024年第7期917-921,927,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：江苏省科技厅重点研发计划项目(BE2021680);江苏省“双创博士”人才计划项目(JSSCBS20211636);连云港市卫生科研项目(QN202006)。

摘　　要：目的观察毫针速刺法联合推拿治疗颈源性眩晕的疗效及对椎-基底动脉血流动力学的影响。方法研究纳入2021年6月—2022年12月于南京中医药大学连云港附属医院就诊的颈源性眩晕患者78例,随机分为试验组38例、对照组40例。试验组采用毫针速刺法联合推拿治疗,由斜方肌起点部条索状痛性结节进针,刺向枕骨和寰椎之间的寰枕筋膜,隔天1次,与推拿治疗交替进行,各治疗7次;对照组予盐酸氟桂利嗪胶囊10 mg每晚口服,连续服用14 d。比较2组患者治疗前后改良颈性眩晕症状与功能评估量表(ESCV)评分、眩晕残障程度评定量表(DHI)评分、椎-基底动脉血流速度,并评定2组临床疗效。结果与治疗前比较,2组患者ESCV评分均明显升高(P均<0.05),DHI评分均明显降低(P均<0.05),且试验组各评分改善程度均明显优于对照组(P均<0.05)。2组治疗前椎-基底动脉血流速度加快的患者,治疗后左椎动脉、右椎动脉、基底动脉血流速度均较治疗前明显减慢(P均<0.05),且试验组右椎动脉、基底动脉血流速度改善程度均明显优于对照组(P均<0.05);2组治疗前椎-基底动脉血流速度减慢的患者,试验组治疗后左椎动脉、右椎动脉、基底动脉血流速度均明显快于治疗前及对照组(P均<0.05),对照组左椎动脉、右椎动脉、基底动脉血流速度均未见明显变化(P均>0.05)。试验组总有效率为94.7%(36/38),明显高于对照组的85.0%(34/40),差异有统计学意义(P<0.05)。结论毫针速刺法联合推拿治疗对颈源性眩晕患者平衡功能有正向调节作用,可实现对椎-基底动脉血流的双向调节,提高患者的生活质量,相对口服盐酸氟桂利嗪胶囊具备一定优势。Objective It is to observe the efficacy of fast filiform needle acupuncture combined with message in the treatment of cervicogenic vertigo and its effect on the hemodynamics of vertebrobasilar artery.Methods Seventy-eight patients with cervicogenic vertigo treated in Lianyungang Affiliated Hospital of Nanjing University of Chinese Medicine from June 2021 to December 2022 were included in the study,and were randomly divided into 38 cases in the experimental group and 40 cases in the control group.The experimental group was treated with fast filiform needle acupuncture combined with message,in which the needle was inserted into the strip like painful nodule from the beginning of the trapezius muscle,and pricked the atlanto-occipital fascia between the occipital bone and atlantoaxial vertebrae once every other day,and alternated with the massage therapy,each treatment was carried out for 7 times;the control group was given Flunarizine Hydrochloride Capsules 10 mg orally per night,continuously treated for 14 days.The Evaluation Scale for Cervical Vertigo(ESCV)scores,Dizziness Handicap Inventory(DHI)scores,blood flow velocity of vertebrobasilar artery of patients in the two groups were compared before and after treatment,and the clinical efficacy of the two groups were assessed.Results Compared with before treatment,the ESCV scores of the two groups were significantly increased(both P<0.05),while DHI scores were significantly decreased(all P<0.05),and the improvements of the scores of the experimental group were significantly better than those of the control group(all P<0.05).In the patients of the two groups with accelerated blood flow velocity of vertebrobasilar artery before treatment,the blood flow velocities of left vertebral artery,right vertebral artery and basilar artery were significantly slower after treatment than those before treatment(all P<0.05),and the improvements of blood flow velocities of the right vertebral artery and basilar artery of the experimental group were significantly better than those of

关 键 词：颈源性眩晕 毫针速刺法 推拿 椎-基底动脉 血流动力学 

分 类 号：R441.2[医药卫生—诊断学]